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Bone mineral content is lower in prepubertal HIV-infected children

Stephen M Arpadi1, Mary Horlick, John Thornton

  • 1Comprehensive Care Center, St. Luke's-Roosevelt Hospital Center, 1111 Amsterdam Avenue, New York, NY 10025, U.S.A. smarpadi@pol.net

Insights

Prepubertal children with HIV have lower total body bone mineral content (TBBMC) than healthy children. This bone density reduction persists even after accounting for various factors, increasing their risk for osteoporosis.

Area of Science:

  • Pediatric Endocrinology
  • Infectious Diseases
  • Bone Metabolism

Background:

  • Human immunodeficiency virus (HIV) infection can impact various aspects of child development.
  • Bone health is a critical component of overall pediatric health and development.
  • Understanding the effects of chronic illness on bone accrual is essential for long-term outcomes.

Purpose of the Study:

  • To compare total body bone mineral content (TBBMC) in prepubertal children with and without HIV infection.
  • To investigate factors influencing TBBMC in HIV-infected children.
  • To assess the potential long-term skeletal health implications for HIV-infected children.

Main Methods:

  • Cross-sectional study design.
  • Dual-energy x-ray absorptiometry (DXA) used for TBBMC measurement.
  • Comparison of TBBMC between 51 HIV-infected and 262 healthy prepubertal children (aged 4.2–14.7 years).
  • Statistical analyses including analysis of covariance to adjust for covariates.

Main Results:

  • HIV-infected children exhibited significantly lower mean TBBMC compared to healthy controls (955 ± 325 g vs. 1,106 ± 273 g, p = .0006).
  • Reduced TBBMC in HIV-positive children remained significant after adjusting for age, sex, and race (p < .001) and also when height and weight were considered (p = .027).
  • The difference in TBBMC between groups increased with age, and no correlation was found with antiretroviral therapy specifics, viral load, or CD4 count within the HIV-positive group.

Conclusions:

  • HIV infection is associated with decreased total body bone mineral content in prepubertal children.
  • Compromised bone mineral accrual in HIV-infected children may elevate their risk for osteoporosis and associated fractures later in life.
  • Further research into interventions to improve bone health in this population is warranted.

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